National Institute for Health and Welfare, Helsinki, Finland.
Ann Med. 2011 Jun;43 Suppl 1:S14-21. doi: 10.3109/07853890.2011.586363.
This article in the supplement issue on the Performance, Effectiveness, and Costs of Treatment episodes (PERFECT)-project describes the PERFECT AMI (acute myocardial infarction) Database, which is developed to measure the performance of hospitals and hospital districts in Finland. We analyse annual trends and regional differences in performance indicators and whether the utilisation of services and costs of hospital care are related to improvement in survival of AMI patients.
The study population consists of ten annual cohorts (1998-2007) of patients hospitalised for AMI.
Since 1998 the treatment pattern has changed rather radically, the utilisation rate of percutaneous coronary intervention (PCI) has increased and coronary procedures have been performed earlier after myocardial infarction. Outcome measured by various measures of mortality has improved considerably. However, trends in the development of the use of services and outcomes are not similar between hospital districts. An increase in cost was positively and statistically significantly related to decrease in mortality, but the effect was not very strong.
There is potential for decreased mortality from actions that do not increase the costs and for enhancing performance in the regions and hospitals with poor performance.
本文是关于治疗效果、效率和成本的表现（PERFECT）项目增刊的一部分，介绍了 PERFECT-AMI（急性心肌梗死）数据库，该数据库旨在衡量芬兰医院和医院区的表现。我们分析了表现指标的年度趋势和地区差异，以及服务利用情况和医院护理成本是否与 AMI 患者生存率的改善相关。
研究人群由十个年度队列（1998-2007 年）的 AMI 住院患者组成。
自 1998 年以来，治疗模式发生了很大变化，经皮冠状动脉介入治疗（PCI）的使用率增加，并且在心肌梗死后更早地进行了冠状动脉手术。通过各种死亡率测量方法衡量的结果有了显著改善。然而，医院区之间服务利用情况和结果的发展趋势并不相似。成本的增加与死亡率的降低呈正相关且具有统计学意义，但效果不是很强。
通过不增加成本的措施降低死亡率是有潜力的，而提高表现较差的地区和医院的表现也是可行的。
